CPAN CPAN Post-Operative Complications and Interventions 1 — Questions and Answers
Question 1: Why is post-operative nausea and vomiting (PONV) a significant concern in the PACU?
- It is a minor inconvenience with no serious clinical significance
- It can cause aspiration, wound dehiscence, increased intracranial pressure, and significant patient distress (Correct answer)
- It is a reliable sign that anesthesia was administered successfully
- It is a condition that only affects pediatric surgical patients
Correct answer: It can cause aspiration, wound dehiscence, increased intracranial pressure, and significant patient distress
PONV is a common post-operative complication that can lead to aspiration, wound dehiscence, elevated intracranial pressure, and significant patient discomfort.
Question 2: Which medication is commonly used as first-line pharmacologic treatment for PONV in the PACU?
- Morphine sulfate
- Ondansetron (Zofran) (Correct answer)
- Metoprolol
- Furosemide
Correct answer: Ondansetron (Zofran)
Ondansetron is a 5-HT3 receptor antagonist commonly used as first-line antiemetic therapy for PONV management in the PACU.
Question 3: What is the underlying cause of post-operative shivering and how should a PACU nurse manage it?
- A sign of infection requiring immediate antibiotic administration
- A thermoregulatory response to hypothermia managed with warming blankets and warm IV fluids (Correct answer)
- A completely normal finding requiring no assessment or intervention
- A sign of anesthetic overdose requiring emergency reversal agents
Correct answer: A thermoregulatory response to hypothermia managed with warming blankets and warm IV fluids
Post-operative shivering is most often caused by hypothermia acquired during surgery and is managed with active warming measures including warm blankets and warmed IV fluids.
Question 4: What is emergence delirium (emergence agitation) in the PACU?
- A planned and expected component of the anesthesia recovery process
- An acute state of confusion, agitation, and disorientation occurring upon emergence from anesthesia (Correct answer)
- Normal sedation expected to follow all types of general anesthesia
- A sign indicating adequate intraoperative pain control was achieved
Correct answer: An acute state of confusion, agitation, and disorientation occurring upon emergence from anesthesia
Emergence delirium is an acute neurological complication characterized by confusion, agitation, and disorientation that can occur during recovery from anesthesia.
Question 5: How should a PACU nurse objectively assess for post-operative hypothermia?
- Ask the patient whether they feel cold and accept their answer
- Monitor core temperature with a reliable thermometer and assess for shivering and vital sign changes (Correct answer)
- Rely on visual inspection of skin color as the primary assessment method
- Rely solely on the patient's subjective complaint of feeling cold
Correct answer: Monitor core temperature with a reliable thermometer and assess for shivering and vital sign changes
Post-operative hypothermia assessment requires objective core temperature measurement in conjunction with clinical signs such as shivering, pallor, and hemodynamic changes.
Question 6: What is post-operative urinary retention (POUR) and what are its key risk factors?
- Normal inability to void for the first 24 hours after any surgery
- Inability to void despite a full bladder, with risk factors including surgery type, older age, and opioid use (Correct answer)
- A urinary tract infection acquired during the surgical procedure
- A sign of appropriate intraoperative fluid management
Correct answer: Inability to void despite a full bladder, with risk factors including surgery type, older age, and opioid use
POUR is the inability to void despite a full bladder and is associated with certain surgery types, advanced age, male gender, and opioid use.
CPAN CPAN Post-Operative Complications and Interventions 1
Why is post-operative nausea and vomiting (PONV) a significant concern in the PACU?